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Suggest Remedy For Obesity Due To The Genetics

Posted on Mon, 29 Jun 2015

Question: I am obese person, 162kg and my height is 1.83 meter.

My obesity is since child hood and I personally believe there is genetic or hormone that causing to be obese all the time.

I have checked my thyroid and is negative, I have also seen another doctor who told me I have hyperinsulin and that is the reason of my obesity, could you please advise what to do.

Thanks

Answered by Dr. Shehzad Topiwala (39 minutes later)

Brief Answer:
Obesity

Detailed Answer:
I do follow what you are saying.

Genetic causes of your excess body weight are possible.

As long as the blood test for TSH and Free T4 are normal, it is extremely unlikely you have a thyroid condition that is contributing to your weight gain.

Regarding the 'hyperinsulin' comment, I would like to say that this is a complex subject but I will try to explain here:

1 Most obese individuals are 'Insulin resistant' ie the insulin which they make is not able to work properly owing to excess fat-related disturbances in the body. The pancreas then ramps up it's insulin production to compensate for the lack of full effect of the insulin. This results in high blood levels of Insulin. This is called 'Hyperinsulinemia'.

So as you can probably see, high insulin is a consequence, and not a cause, of obesity

2 There is a rare condition called Insulinoma which produces excessive insulin in the body. It typically leads to frequent and severe low glucose reactions. Over time, the affected person is subconsciously eating too much to defend against the dangerous low sugar episodes. Such persons tend to gain weight as a result.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (8 hours later)

Thanks for your respond, if i want to make sure what tests do i need to do, in order to find out where the problem lies?

Fyi, i am not diebetic and when i restrict my sugar intake, i feel that i need some sweets.

Please advise what to do.

Thanks

Answered by Dr. Shehzad Topiwala (16 hours later)

Brief Answer:
Follow up

Detailed Answer:
I suggest ruing out two endocrine disorders by running the following tests:

1 Cushing's disease:

It is a rare disease but can cause weight gain.

There are several ways to screen for it but I prefer the Midnight Saliva Cortisol test.

It is important you see an Endocrinologist in person to decide which test to proceed with, because each type of test has challenges interpreting them

2 Acromegaly

Another rare condition that results in weight gain.

A simple random non-fasting blood test called IGF1 levels helps screen for this problem

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (21 hours later)

Thanks for your reply.

The blood test is fine and i will do it.

How can i do mid night saliva cortisol test?. And what tester do I need it?

Please advise

.

Answered by Dr. Shehzad Topiwala (53 minutes later)

Brief Answer:
Second follow up

Detailed Answer:
You will need a doctor's prescription

The laboratory will then give you a kit with detailed instructions on how to perform the test

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (13 minutes later)

Is it possible to give me a prescription ?.

I have second question relating endocrinologist and it is as follows.

I am going to undergo micro dissection of sperm retrieval, my hormone levels are high.
Fsh 19

Testerone 37

LH 18

Could you please advise chances to increase success of retrieving sperm.

Kindly advise.

Answered by Dr. Shehzad Topiwala (13 hours later)

Brief Answer:
Third follow up

Detailed Answer:
I am sorry it is not possible to prescribe anything on this forum.

Regarding the new question you have posed, it appears you have a condition called

Hypergonadotrophic Hypogonadism. This complex word is also described as Primary Testicular Failure.

It is possible you may have a condition called Klinefelter's syndrome. It can cause excess body weight too.

Please talk to your doctor about this and consider getting a blood test called Karyotype for detecting this medical condition.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

I have checked my chromosome kyrotype and is normal 46 xy.

My hormone levels were normal, then a Doctor prescribed clomid and and after taking clomid nearly 9 months every went up 100% from 9.2 to 18.

Please advise what do you think?

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Fourth follow up

Detailed Answer:
This matter requires an opportunity to perform a physical examination including that of the genitals to measure SPL (Stretched Penile Length) and testicular volumes, in addition to a thorough general examination.
I strongly suggest you get yourself comprehensively evaluated by an endocrinologist in person

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar